Dartmouth's unique strengths are exemplified by advances in Patient Centered Outcomes Research (PCOR) by researchers at The Dartmouth Institute for Health Policy and Clinical Practice (TDI) and The Dartmouth Center for Health Care Delivery Science (TDC). We propose to contribute to developing the next generation of leaders in PCOR by establishing an Early Career Development Program for Patient Centered Outcomes Research with the following three specific aims: Aim 1: To provide mentored research opportunities for 4 AHRQ and 2 Dartmouth-supported PCOR K12 scholars to establish PCOR research skills, develop preliminary pilot data, and write first-authored manuscripts in one of the following three areas of specific strength: a) Comparative effectiveness research using patient-reported outcomes to evaluate emerging models of integrated medical homes and accountable care organizations; b) Comparative effectiveness research evaluating outcomes of care to inform decision-making related to common, high cost, complex health conditions; or c) Patient-oriented, community-based randomized trials and implementation research focusing on reducing health disparities in vulnerable populations. Aim 2: To enhance early career investigator competencies through a combination of individually-tailored mentoring, formal coursework and early career investigator works in progress seminars provided by TDI, TDC, and affiliate research programs. Scholars will acquire research skills through an individually tailored mentoring program, a PCOR seminar, an early career development seminar, and a Mentoring Academy that will enhance senior faculty mentoring skills for PCOR research career development. Aim 3: To provide effective senior mentoring and consultative support for the development and submission of a first externally funded K, R01, or other independent research proposal. Scholars will be guided by a one-week research career and grant skill development boot camp; a nine-month grant writing tutorial resulting in a completed grant application; and an internal peer review process for grant applications. This program is designed to advance the skills and research careers of highly promising early career investigators in PCOR by capitalizing on numerous innovative features including local, regional, and national health services research laboratories; mentoring in innovative PCOR methods; a novel research career mentoring program structured to ensure success in attaining a first externally funded career development (K) or R01 research award; and substantial institutional support that maximizes the number of scholars and programmatic resources.